Individual provider Active NPI

Leslie Ro

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1790240992
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
126773 Issued in CA
Practice address
12555 W Jefferson Blvd Ste 301
Los Angeles, CA 90066-7032
Phone
(424) 443-5555
NPI assigned
Feb 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 126773 CA Primary

Addresses

Primary practice location

12555 W Jefferson Blvd Ste 301
Los Angeles, CA 90066-7032

Mailing address

12555 W Jefferson Blvd Ste 301
Los Angeles, CA 90066-7032

Other practice location 1

PO Box 802131
Santa Clarita, CA 91380-2131
Phone (661) 425-2342

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801001404 CA Practitioner - Clinical Social Worker 0345758371 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
126773CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Saint Johns Medical Foundation CurrentSince Jul 18, 2025 Accepting new patients

Locations

12555 W Jefferson Blvd
#301
Los Angeles, CA 90066
Phone (424) 443-5555

2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024

2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1790240992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12555 W JEFFERSON BLVD STE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12555 W JEFFERSON BLVD STE 301",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900667032",
            "telephone_number": "424-443-5555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 802131",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913802131",
            "country_code": "US",
            "telephone_number": "661-425-2342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RO",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "126773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.